19-year-old transgender male, am I eligible for keyhole/peri? (Photos)

Thank you for your question and photos. Due to the relatively small breasts, you will get a great result with VASER liposuction of the chest and breasts and breast tissue excision via intra-areolar (not keyhole or periareolar incisions, those leave visible scars) incisions. I do these surgeries in our certified office surgery suite under deep intravenous sedation and tumescent anesthesia only. The intra areolar incision will not leave visible scars. See a board certified plastic surgeon experienced in advanced body sculpting techniques for an in person consultation/evaluation. Good luck.
See attached web reference.

Eligibility for a periareolar top surgery depends on several factors, including the amount of excess skin and breast tissue you have, as well as your goals for scarring and the final appearance. The periareolar approach involves making incisions around the areola and is often preferred for minimal scarring. This technique is particularly effective for individuals with mild to moderate skin laxity, as in your case, as it allows for the removal of excess skin while tightening the remaining tissue. It's recommended to schedule a consultation with a plastic surgeon specializing in gender-affirming top surgery or breast surgery to evaluate your options and help guide you through the process.
Krishna Vyas, MD, PhD, MHSHarvard and Mayo Clinic Trained Aesthetic and Plastic SurgeonNew York, New York

If you're considering a periareolar approach with a circular (donut) skin excision and are interested in minimal scarring while achieving a natural look, this method could potentially be suitable. The periareolar technique is often favored for its less visible scarring as the incisions are made around the areola. Adding a circular skin excision helps to remove excess skin while tightening the remaining skin, which can be particularly beneficial if you have mild to moderate skin laxity but not a large amount of excess skin.
Additionally, incorporating Renuvion, a skin tightening procedure that uses plasma technology, can further enhance the final shape by providing additional tightening effects. This could be a great complement to the surgery, helping to achieve a more contoured, masculine appearance with smoother results.